（优质医学）胃癌新辅助化疗-最新进展.ppt

亚洲人群其它新辅助化疗方案 一项中国II期单臂临床实验采用XELOX方案新辅助化疗联合手术治疗腹主动脉旁淋巴结转移胃癌。48名患者入组，RR 49%，28名接受手术，PFS OS分别为10和29.8个月 一项III期临床试验PRODIGY，入组640名T2-3N+或T4患者采用3周期DOS新辅助化疗或单纯手术治疗，两组患者均接受术后一年的替吉奥单药口服。主要中点为PFS，次要研究终点为OS，降期，R0切除率。目前仍在招募中。 1 胃癌新辅助治疗模式东西方存在差异 亚洲多项II期临床实验的结果显示了采用多种化疗方案新辅助化疗 结合手术治疗对于高度选择的边界可切除胃癌患者有确切疗效，III期 临床试验的结果值得我们期待。 由于Dutch实验长期随访数据显示接受D2根治术的患者可以达到较低 的局部复发率和更长的PFS，所以目前在很多西方国家，D2根治术也 被推荐为标准的手术方式 小结 1 * Countries with highest prevalence of gastric cancer are highlighted in yellow based on age standardized incidence risk (ASR) in men 20 / 100 000 by region [1]. Regions highlighted in green represent countries with ASR for gastric cancer in men ≥10 and ?20 / 100 000. Regions highlighted in cyan (light blue) represent countries with a low incidence of gastric cancer (ASR in men 10 / 100 000). Approximately two-thirds of gastric cancer cases occur in less developed countries with the highest incidence rates in the Asia-Pacific region. Areas with the highest incidence of gastric cancer include Japan, China, Korea, Central and South America, Eastern Europe, and the Middle East. Japan has the highest incidence rate for gastric cancer in the world (62.1 ASR in men / 100 000). The majority of gastric cancer cases (42%) occur in China [2]. There is a low incidence rate in North America, Northern Europe, Australia/New Zealand, and India [1,2]. In the US, there are approximately 22 000 new cases of gastric cancer diagnosed per year [3]. Worldwide: 900 000 new cases and 700 000 deaths per year due to gastric cancer. 5-year survival-rate for gastric cancer is ?20%. gastric cancer is the second leading cause of cancer death in the world [2]. 1. Parkin DM et al. CA Cancer J Clin 2005;55:74–108. 2. Yang L. World J Gastroenterol 2006;12;17–20. 3. . 胃癌高发地区：辽宁、山东、甘肃、江苏、福建、云南。中年男性是主力。诱发因素：暴饮暴食、饮酒过度、饮食习惯（爱吃高盐、腌制食品，特别是没腌透的食品，其中含有较高的致癌物亚硝酸盐）。专家支招：多吃绿色、黄色蔬菜；少吃咸、腌、干硬、发霉的食物；限酒；40岁以上的男性有家族史、慢性胃病史、合并Hp感染的人应定期体检。 以上海市为例